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New Medicare Billing Rules: What MFTs, MHCs, and IOP Providers Need to Know

Client Alert

Starting January 1, 2024, Medicare began covering services provided to Medicare beneficiaries by marriage and family therapists, mental health counselors, and Intensive Outpatient Program (IOP) services. With this change, Medicare has become the primary payer for these services. 

To allow providers time to enroll in Medicare, the Ohio Department of Medicaid (ODM) and MyCare Ohio plans have continued to pay claims for these services for Medicaid enrollees with dual Medicare and Medicaid eligibility through June 30, 2024. Once providers are enrolled with Medicare, claims must be submitted to Medicare before the provider seeks cost-sharing reimbursement from Medicaid.

In compliance with these updates, ODM recently announced updates to its Medicare and Third-Party Liability Bypass List, effective July 1, 2024. The Bypass List, organized by procedure code, indicates which provider types may bypass Medicare and bill Medicaid directly. The list has been updated to reflect the small set of provider types now eligible to bypass Medicare.

Please contact BMD Healthcare Member Daphne Kackloudis at dlkackloudis@bmdllc.com or Attorney Jordan Burdick at jaburdick@bmdllc.com with any questions.


Trump vs. Harris: What Could Their Presidencies Mean for Employment Law?

In the latest 2 episodes of Employment Law After Hours, BMD Partner Bryan Meeks dives deep into the potential employment law changes we could see under two very different 2024 election outcomes with Kamala Harris or Donald Trump.

Charitable Planning: A Menu of Options

Find out ways you can take advantage of charitable planning to minimize the amount of estate taxes due. Here are some of the popular charitable planning techniques, their uses, and some general advice regarding their formation.

Nationwide Ban on Non-Compete Agreements: Requirements and Texas Court Decision Explained

Watch this Employment Law After Hours video to find out about the Federal Trade Commission’s (FTC) groundbreaking Final Rule that bans non-compete agreements nationwide. This video also explores the recent decision by the Northern District of Texas to enjoin and delay the implementation and enforcement of the Final Rule banning non-compete agreements nationwide.

Parental Approval Mandate for Diagnosing Gender-Related Conditions in Minors under Ohio House Bill 68

Ohio House Bill 68, effective August 6, 2024, introduces strict guidelines for mental health professionals diagnosing and treating minors with gender-related conditions. The law mandates parental or guardian consent before any diagnosis or treatment can proceed. Additionally, professionals must first screen for other comorbidities and assess for any history of abuse. Failure to adhere to these requirements can result in disciplinary action for unprofessional conduct.

Navigate the Latest Employment Law Changes with Confidence

BMD Partner and Co-Chair of the Employment & Labor Law Group, Bryan Meek, presented this webinar on trending HR topics. Topics include the new Fair Labor Standards Act changes for exempt employees and Federal Trade Commission's nationwide ban on non-competes. Discover how these groundbreaking changes will impact organizations nationwide and what they need to do to ensure compliance.